Detection of disseminated pancreatic cells by amplification of cytokeratin-19 with quantiative RT-PCR in blood, bone marrow and peritoneal lavage of pancreatic carcinoma patients
Detection of disseminated pancreatic cells by amplification of cytokeratin-19 with quantiative RT-PCR in blood, bone marrow and peritoneal lavage of pancreatic carcinoma patients
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DOI：
10.3748/wjg.v13.i2.257
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发表时间：
2007-01-14
影响因子：
4.3
通讯作者：
Witzigmann, Helmut
中科院分区：
文献类型：
--
作者：
Hoffmann, Katrin;Kerner, Christiane;Witzigmann, Helmut
目的：探讨细胞角蛋白19 (CK-19) mRNA在胰腺导管腺癌患者血液、骨髓及腹腔灌洗液中弥散性肿瘤细胞检测中的诊断价值。方法：68例胰腺癌（n = 37）、慢性胰腺炎（n = 16）和非胰腺良性手术疾病（n = 15，对照组）纳入研究。术前、术中及术后第1、10天取静脉血。分析术前骨髓抽吸及肿瘤移动前腹腔灌洗。所有样本均采用ck -19特异性巢式pcr和荧光定量RT-PCR检测弥散性肿瘤细胞。结果：胰腺癌患者血液标本24例（64%）、腹腔灌洗标本11例（30%）CK-19 mRNA表达升高。在15例（40%）胰腺癌患者中，在静脉血、骨髓和/或腹腔灌洗液中检测到弥散性肿瘤细胞。在腹腔灌洗中，检出率与肿瘤大小和肿瘤分化程度有关。CK-19水平在pT3/T4和中/低分化肿瘤（G2/G3）中升高。至少有一个CK-19 mrna阳性样本的胰腺癌患者的生存期有缩短的趋势。胰腺癌患者血液和腹腔灌洗液中弥散性肿瘤细胞的检出率明显高于对照组和慢性胰腺炎患者。结论：CK-19荧光RT-PCR可检测胰腺导管腺癌患者弥散性肿瘤细胞。在腹腔灌洗中，检出率与肿瘤分期和分化有关。在临床应用中，CK-19与其他肿瘤特异性标志物联合适用于区分胰腺疾病的良恶性。(c) 2007年WIG出版社。版权所有。
AIM: To evaluate the diagnostic potential of cytokeratin-19 (CK-19) mRNA for the detection of disseminated tumor cells in blood, bone marrow and peritoneal lavage in patients with ductal adenocarcinoma of the pancreas.METHODS: Sixty-eight patients with pancreatic cancer (n = 37), chronic pancreatitis (n = 16), and non-pancreatic benign surgical diseases (n 15, control group) were included in the study. Venous blood was taken preoperatively, intraoperatively and at postoperative d 1 and 10. Preoperative bone marrow aspirates and peritoneal lavage taken before mobilization of the tumor were analyzed. All samples were evaluated for disseminated tumor cells by CK-19-specific nested-PCR and quantitative fluorogenic RT-PCR.RESULTS: CK-19 mRNA expression was increased in 24 (64%) blood samples and 11 (30%) of the peritoneal lavage samples in the patients with pancreatic cancer. In 15 (40%) of the patients with pancreatic cancer, disseminated tumor cells were detected in venous blood and bone marrow and/or peritoneal lavage. In the peritoneal lavage, the detection rates were correlated with the tumor size and the tumor differentiation. CK-19 levels were increased in pT3/T4 and moderately/poorly differentiated tumors (G2/G3). Pancreatic cancer patients with at least one CK-19 mRNA-positive sample showed a trend towards shorter survival. Pancreatic cancer patients showed significantly increased detection rates of disseminated tumor cells in blood and peritoneal lavage compared to the controls and the patients with chronic pancreatitis.CONCLUSION: Disseminated tumor cells can be detected in patients with pancreatic ductal adenocarcinoma by CK-19 fluorogenic RT-PCR. In peritoneal lavage, detection rate is correlated with tumor stage and differentiation. In the clinical use, CK-19 is suitable for the distinction between malignant and benign pancreatic disease in combination with other tumor-specific markers. (c) 2007 The WIG Press. All rights reserved.